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241 results on '"Alderman, E. L."'

3. Clinical application of a light-pen computer system for quantitative angiography

Author

Alderman, E. L

Subjects
Aerospace Medicine
Abstract

The paper describes an angiographic analysis system which uses a video disk for recording and playback, a light-pen for data input, minicomputer processing, and an electrostatic printer/plotter for hardcopy output. The method is applied to quantitative analysis of ventricular volumes, sequential ventriculography for assessment of physiologic and pharmacologic interventions, analysis of instantaneous time sequence of ventricular systolic and diastolic events, and quantitation of segmental abnormalities. The system is shown to provide the capability for computation of ventricular volumes and other measurements from operator-defined margins by greatly reducing the tedium and errors associated with manual planimetry.

Published
1975

4. Alterations in left ventricular volumes induced by Valsalva manoeuvre

Author

Brooker, J. Z, Alderman, E. L, and Harrison, D. C

Subjects
Biosciences
Abstract

Five patients were studied with left ventriculography during different phases of the Valsalva manoeuvre. Small doses of contrast medium allowed adequate repetitive visualization of the left ventricle for volume calculation. During strain phase, the volume of the left ventricle decreased by nearly 50 per cent in each case, and stroke volume and cardiac output also dropped strikingly. Release of straining was attended by a sharp rebound of left ventricular volume to control levels, with a transient surge of increased cardiac output 42 per cent above that of the resting state.

Published
1974

5. Evaluation of the pulse-contour method of determining stroke volume in man.

Author

Alderman, E. L, Branzi, A, Sanders, W, Brown, B. W, and Harrison, D. C

Subjects
Biosciences
Abstract

The pulse-contour method for determining stroke volume has been employed as a continuous rapid method of monitoring the cardiovascular status of patients. Twenty-one patients with ischemic heart disease and 21 patients with mitral valve disease were subjected to a variety of hemodynamic interventions. The pulse-contour estimations, using three different formulas derived by Warner, Kouchoukos, and Herd, were compared with indicator-dilution outputs. A comparison of the results of the two methods for determining stroke volume yielded correlation coefficients ranging from 0.59 to 0.84. The better performing Warner formula yielded a coefficient of variation of about 20%. The type of hemodynamic interventions employed did not significantly affect the results using the pulse-contour method. Although the correlation of the pulse-contour and indicator-dilution stroke volumes is high, the coefficient of variation is such that small changes in stroke volume cannot be accurately assessed by the pulse-contour method. However, the simplicity and rapidity of this method compared to determination of cardiac output by Fick or indicator-dilution methods makes it a potentially useful adjunct for monitoring critically ill patients.

Published
1972

9. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP).

Author

Haskell, W L, primary, Alderman, E L, additional, Fair, J M, additional, Maron, D J, additional, Mackey, S F, additional, Superko, H R, additional, Williams, P T, additional, Johnstone, I M, additional, Champagne, M A, additional, and Krauss, R M, additional

Published
1994
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25. Circulatory response to vasodilator therapy in congestive cardiomyopathy.

Author

Rossen, R M, Alderman, E L, and Harrison, D C

Abstract

Vasodilator therapy has been shown to have beneficial effects in heart failure. In order to evaluate the haemodynamic actions of vasodilator administration in primary congestive cardiomyopathy, sodium nitroprusside was infused intravenously at a rate of 15 to 100 mug/min to 12 patients. Mean arterial pressure fell 15 per cent from 86+/-3-0 to 72+/-2-4 mmHg (11-40 +/- -4 to 9-6 +/- 0-3 kPa), and there was a small but significant decrease in mean heart rate from 96 +/- 4-8 to 90 +/- 4-4 beats/min. These changes were accompanied by a significant decrease in mean pulmonary artery pressure from 40 +/- 2-2 to 26 +/- 2-8 mmHg (5-3 +/- 0-3 kPa to 3-5 +/- 0-4 kPa), mean pulmonary capillary wedge pressure from 25 +/ -2-2 to 16 +/- 2-1 mmHg (3-3 +/- 0-3 to 2-1 +/- 0-3 kPa), and left ventricular end-diastolic pressure from 27 +/- 1-8 to 17 +/- 1-5 mmHg (3-6 +/- 0-3 to 2-3 +/- 0-2 kPa). Cardiac index increased by an average of 48 per cent from 2-1 to 3-1 l/min per m2, and left ventricular stroke work index increased from 18-4 +/- 1-6 to 21-3 +/- 1-9 g m/m2. These results show that pronounced left ventricular dysfunction in patients with congestive cardiomyopathy is improved during vasodilator therapy. [ABSTRACT FROM PUBLISHER]

Published
1976
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26. Effect of propranolol on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man.

Author

Coltart, J, Alderman, E L, Robison, S C, and Harrison, D C

Abstract

Precise quantitation of the effects of the non-selective beta adrenergic blocking drug propranolol (3.15 mg/kg body weight) on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man has been performed. High fidelity left ventricular pressure measurements and simultaneous single-plane angiocardiograms were recorded on a video disc and volumes calculated by a light-pen computer system. Systolic segmental wall motion was computer analysed using the long axis-quadrasection method. Patients were transvenously atrially paced to maintain a constant heart rate. The haemodynamic effects of propranolol may vary depending upon the extent of pre-existing myocardial disease. In some patients ventricular function, as measured by ejection fraction, may be reduced. This reduction in ejection fraction appears to result from overall reduction in segmental wall motion, but also from accentuation of segmental wall abnormalities. These results are consistent with the thesis that beta adrenergic blocking drugs may inhibit compensatory sympathetic mechanisms. The diastolic effects of propranolol may include quite substantial increases in ventricular volumes in those patients with impaired cardiac function. With respect to the intact human ventricle, propranolol may increase diastolic volume for a given level of ventricular pressure. Thus, in a static sense, the ventricle in these patients could be viewed as being more compliant after propranolol administration. However, the fact that the length-tension relation, as measured by the slope of the logarithmic pressure versus volume plot is unaltered by propranolol, suggests that the muscle comprising the ventricle itself exhibits no alteration in its passive elastic properties. [ABSTRACT FROM PUBLISHER]

Published
1975
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28. Treatment of recurrent symptomatic ventricular tachycardia.

Author

Winkle, Roger A., Alderman, Edwin L., Fitgerald, John W., Harrison, Donald C., Winkle, R A, Alderman, E L, Fitzgerald, J W, and Harrison, D C

Subjects
VENTRICULAR tachycardia, TACHYCARDIA treatment, THERAPEUTICS
Abstract

Eleven consecutive patients with recurrent ventricular arrhythmias were treated by an aggressive protocol and followed up prospectively. Arrhythmias, symptoms, and cardiac lesions were defined. Antiarrhythmic drugs were given on schedule, with blood levels determining dose; success or failure was defined by elimination or recurrence of symptomatic arrhythmias. When drug therapy failed, left ventricular aneurysmectomy was done when appropriate. Recurrent ventricular tachycardia was most frequently responsible for symptoms; coronary artery disease was the most frequent underlying disease. Symptomatic arrhythmias were eliminated in 8 of 11 patients (5 with drugs and 3 with aneurysmectomies), with a 16.5-month symptom-free average follow-up. An average of 2.9 therapeutic trials per patient was needed to control symptomatic arrhythmias. The average time from entry into the study until the start of ultimately effective therapy was 18 days. Therapy that eliminated symptoms did not eliminate all premature ventricular contractions, and occasionally even brief asymptomatic episodes of ventricular tachycardia persisted. Recurrent symptomatic ventricular arrhythmias can be controlled in many patients by rigorous application of current therapies. [ABSTRACT FROM AUTHOR]

Published
1976
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29. Relation of P-S4 interval to left ventricular end-diastolic pressure.

Author

Schapira, J N, Fowles, R E, Bowden, R E, Alderman, E L, and Popp, R L

Abstract

Reports have suggested that the interval between P wave onset and the fourth heart sound (P-S4 interval) reflects changes in left ventricular myocardial stiffness. We made simultaneous measurements of the P-S4 or atrial electrogram to S4 (A-S4) interval and left ventricular pressure in 19 patients with coronary artery disease who were studied before and after atrial pacing. Thirteen patients developed angina accompanied by significant rises in their end-diastolic pressure and a consistent decrease in P-S4 or A-S4 interval; whereas the six patients who had atrial pacing without the development of angina had no change in end-diastolic pressure, P-S4, or A-S4 interval. The resting data showed in inverse correlation between left ventricular end-diastolic pressure and the P-S4 interval. In addition, the P-S4 interval let us discriminate between patients with normal and abnormal end-diastolic pressure (greater than 15 mmHg). [ABSTRACT FROM PUBLISHER]

Published
1982
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33. Coronary artery syndromes after sudden propranolol withdrawal.

Author

Alderman, Edwin L., Coltart, John, Wettach, George E., Harrison, Donald C., Alderman, E L, Coltart, D J, Wettach, G E, and Harrison, D C

Subjects
ANGINA pectoris, THERAPEUTICS, DRUG therapy for angina pectoris, THERAPEUTIC use of nitroglycerin, DRUG withdrawal symptoms, ELECTROCARDIOGRAPHY, MYOCARDIAL infarction, SUDDEN death, PROPRANOLOL
Abstract

Describes cases of patients with stable exertional angina pectoris that developed unstable angina after cessation of propranolol therapy.

Published
1974
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44. Use of survival analysis to determine the clinical significance of new Q waves after coronary bypass surgery.

Author

Chaitman, B R, primary, Alderman, E L, additional, Sheffield, L T, additional, Tong, T, additional, Fisher, L, additional, Mock, M B, additional, Weins, R D, additional, Kaiser, G C, additional, Roitman, D, additional, Berger, R, additional, Gersh, B, additional, Schaff, H, additional, Bourassa, M G, additional, and Killip, T, additional

Published
1983
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49. Prognostic value of angiographic indices of coronary artery disease from the Coronary Artery Surgery Study (CASS).

Author

Ringqvist, I, primary, Fisher, L D, additional, Mock, M, additional, Davis, K B, additional, Wedel, H, additional, Chaitman, B R, additional, Passamani, E, additional, Russell, R O, additional, Alderman, E L, additional, Kouchoukas, N T, additional, Kaiser, G C, additional, Ryan, T J, additional, Killip, T, additional, and Fray, D, additional

Published
1983
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